Provider Demographics
NPI:1629687520
Name:FRONTLINE RECOVERY CENTER, INC
Entity Type:Organization
Organization Name:FRONTLINE RECOVERY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HERVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCK
Authorized Official - Suffix:
Authorized Official - Credentials:CAP
Authorized Official - Phone:786-273-1807
Mailing Address - Street 1:6503 SW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-4808
Mailing Address - Country:US
Mailing Address - Phone:786-273-1807
Mailing Address - Fax:
Practice Address - Street 1:6503 SW 19TH ST
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-4808
Practice Address - Country:US
Practice Address - Phone:786-273-1807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility